Correlation between Left Ventricular Outflow Tract Velocity Time Integral and Degree of Mitral Regurgitation in Patients with Preserved Ejection Fraction
Ossama Maadarani*, Hany Alfayed, Zouheir Bitar, Rashed Alhamdan, Moataz Daher
Background: Mitral regurgitation (MR) assessment and quantification is a daily practice in echocardiographic laboratory. Although there are qualitative (visual assessment), semiquantitative and quantitative methods for MR severity assessment, it is still a challenging issue. Aim: To investigates the relationship between left ventricle outflow tract velocity time integral (LVOT VTI) and the degree of MR in patient with preserved ejection fraction (EF).
Methods: This paper reports a prospective observational study of 29 patients who underwent two-dimensional (2D) transthoracic echocardiography (TTE) to assess MR in patients with preserved EF.
Result: 29 participants were included in the study. 27 of the 29 patients had LVOT VTI >14 cm and 2 patients had LVOT VTI < 14 cm. The regurgitant volume ( RV) was less than 60 ml/beat in the group of patients with LVOT VTI >14 cm wherein the group of patients with LVOT VTI < 14 cm RV was more than 60 ml/beat. The sensitivity and specificity were 100% and 96.15% respectively with positive predictive value of 66.67% and marked negative predictive value of 100%, giving accuracy of 96.43%.
Conclusion: The Value of left ventricular outflow tract velocity time integral can be used indirectly to separate between mild and severe MR in patients with preserved systolic function. In patients with MR, LVOT VTI of less than 14 cm indirectly indicates severe MR as the RV is expected to exceed 60 ml per beat.